via Health Reform Watch: HHS Grants $727 Million To Community Health Centers. This money is funded out of $11 Billion allocated in the much-derided PPACA (health care reform law) for construction and expansion of CHCs, and is on top of $2 Billion allocated for that purpose in the ARRA (Stimulus act). We have a new three-story CHC going up down the block from our hospital, replacing a much, much smaller older clinic. Given how overburdened they are with underserved patients, this may have a great effect increasing access to care in our community.

Pay on Wall Street is on pace to break a record high for a second consecutive year, according to a study conducted by The Wall Street Journal.

Oh, well. Problem solved. You're welcome.

This is depressing: apparently GM's been lying about the Volt, their new electric car. Promoted as all-electric drive and capable of 230 mpg, it appears that it's actually good for about 37 mpg and about 30 miles of electric-only operation, and the gas engine does power the wheels. So it's basically a bigger, less efficient plug-in version of the Prius. OK, I guess, but way way short of the hype.

This is not to be missed. Colbert tears apart Republican Rich Iott, who wore a Waffen SS uniform as part of a Nazi-re-enactment hobby.

Best line: Iott said his Nazi reenactment was simply "a father-son bonding thing." Colbert said: "That's right. Fathers bond with their sons in all kinds of ways. Building a boat, fixing the car, solving the Jewish problem."

4 comments:

I'm an American whi migrated to Canada in 2004. I became a citizen in 2009.I live in a small coastal community in British Columbia. I love the medical care here. We don't have a big hospital but the local acute care hospital is well-equpped and staffed with able and compassionate people. For specialists we go into Vancouver. (A ferry ride away.)I'm 68 now, so having a great GP is very comforting.When I lived in the US, I also had access to wonderful doctors and nurses but the cost of insurance was rapidly approaching prohibitive. Here the insurance for a couple is $102 per month. No matter how tough things get, at least decent medical care isn't something I have to worry about.

What's wrong with means-testing Medicare? If someone can afford cigarettes and an iPhone, then that person has about $200/month that could go towards healthcare. Or would it be unfair to require someone who wishes to spend my tax money to spend his own money first?

First, Medicare is not exactly supported by *your* tax dollars. Current beneficiaries are receiving benefits which they contributed to during their working lives. Which is why it's an entitlement. You are paying in to support your future benefits, at least in theory.

One POLICY-based argument against means testing it from a political point of view is that the promise was made to Americans that if they paid into medicare it would be there for them, and so it would represent something of a bait and switch. Higher income folks paid into it for their entire lives and then receive less of the benefit. Is that fair? It may depend whether you view medicare as a pay as you go (current working generation supporting the current retirees) or it's a prepaid insurance plan (which the trust fund concept implies). It's complicated -- and it's a fair debate, for those politicians brave/foolish enough to engage it.

The POLITICAL argument against means testing is that it could be used as a back door to dismantling the program. Medicare's popularity is due to the fact that it's universal. If means testing is introduced, it likely gets expanded over subsequent years, due to budgetary pressures, and ultimately it becomes a much smaller program targeted only to the poor. Some people on the right would very much view that as a desirable outcome. Those of us who view the universality of medicare as a key feature will oppose it for that reason.

Finally, bear in mind that I was making fun of Paul for the rookie mistake of saying something terribly unpopular in an election campaign and then trying like hell to run away from it, in addition to his general policy incoherence.

The link to the Chevy Volt story is broken; it links back to the previous story on Wall Street salaries. I think the story you were looking for was http://www.luxist.com/2010/10/11/41-000-chevy-volt-draws-controversy-for-engineering-claims/ .

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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This blog is for general discussion, education, entertainment and amusement. Nothing written here constitutes medical advice nor are any hypothetical cases discussed intended to be construed as medical advice. Please do not contact me with specific medical questions or concerns. All clinical cases on this blog are presented for educational or general interest purposes and every attempt has been made to ensure that patient confidentiality and HIPAA are respected. All cases are fictionalized, either in part or in whole, depending on how much I needed to embellish to make it a good story to protect patient privacy.

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